Addiction ravaging Afghanistan called ‘a tsunami’

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Users prepared to take their drug of choice — opium, heroin, or crystal methamphetamine — in an area where hundreds of addicts congregate near Herat, Afghanistan.

By Azam AhmedNew York Times
November 03, 2013

ISLAM QALA, Afghanistan — The addicts stalk the streets of this border post like hollowed-out skeletons, hair matted by filth and eyes glassy. The villages that hug the roads are veritable zombie towns, where families of men, women, and children hide their addiction within barren mud compounds.

“Sometimes I feel it is better to die than live like this,” said Haidar, 30, seated on the floor of his living room beside a small tin of sugarlike powder.

His family, a wife and young children, bore the gaunt faces of addiction as well.

In western Herat province, held up as an island of stability and progress in Afghanistan, the forlorn border town of Islam Qala is instead a showcase for an intensifying crisis: Long the global leader in opium production, Afghanistan has now also become one of the world’s most addicted societies.

The number of drug users in Afghanistan is estimated to be as high as 1.6 million, or about 5.3 percent of the population, among the highest rates in the world. Nationwide, 1 in 10 urban households has at least one drug user, according to a recent report from the Bureau of International Narcotics and Law Enforcement Affairs. In the city of Herat, it is 1 in 5.

From 2005 to 2009, the use of opiates doubled, according to the UN Office on Drugs and Crime, putting Afghanistan on par with Russia and Iran, and the number of heroin users jumped more than 140 percent. Most drug experts think the rate of drug use has increased since then.

In a country troubled by adversity, from its long-running war to rampant corruption, drug addiction ranks low among national priorities. Government funding for treatment and outreach is less than $4 million a year.

There are just under 28,000 formal treatment slots available nationwide, officials say, and such programs rely heavily on roughly $12 million a year in extra international funding for treatment.

The focus of the international community and the Afghan government has instead been on reducing opium production. Since the beginning of the war in 2001, the Americans have spent more than $6 billion to curb Afghanistan’s opium industry, including eradication and alternative crop subsidies.

The effort has struggled, and in many areas eradication efforts have been unofficially abandoned as too costly in terms of lost public support for government.

In the last two years, opium cultivation has increased to the highest level since 2008, as global demand and prices remain robust.

The sheer volume of supply has fueled domestic demand, a phenomenon the UN drug czar in Afghanistan refers to as “the Coca-Cola effect,” after the company’s market-saturation tactics.

Cementing the status quo is a lack of treatment options, like methadone substitution, or a holistic plan to address the crisis.

“This is a tsunami for our country,” said Dr. Ahmad Fawad Osmani, the director of drug demand reduction for the Ministry of Public Health. “The only thing our drug production has brought us is 1 million drug users.”

While it has grown far worse in the past few years, the drug crisis in Afghanistan is not new. International health officials caught on early to the problem, which in some measure stemmed from the traditional use of opium for medication.

In fact, one of the earliest challenges Afghan security forces had to surmount was a public image as a band of opium-addled thieves.

The problem, while more controlled, still exists: Just last month, the nation’s intelligence agency, the National Directorate of Security, fired 65 employees after discovering that they were addicted to opium.

In rural areas, the problem is expected to be worse. In some villages, the rate of drug use is as high as 30 percent of the population, based on hair, urine, and saliva samples taken by the authors of the urban study. And drugs not traditionally in wide use here, including crystal methamphetamine, are now figuring in the problem as well.